Feedback in the OSCE: What Do Residents Remember?

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Healthcare Professional Development

Background:

• Competency-based education emphasizes direct observation and effective feedback in clinical settings.
• Objective Structured Clinical Examinations (OSCEs) are crucial for assessing clinical skills and providing simultaneous feedback.
• Effective feedback requires observation, assessment, feedback delivery, reflection, decision-making, and application for learning.

Purpose of the Study:

• To determine the quantity and accuracy of feedback recalled by trainees immediately after and one month following an OSCE.
• To assess if immediate recall prompts enhance delayed recall of OSCE feedback.
• To evaluate the long-term retention and representativeness of feedback provided during OSCEs.

Main Methods:

• Internal medicine residents received 2-minute verbal feedback post-OSCE, which was audio-recorded and transcribed.
• Residents were randomized into an immediate recall group (questionnaire immediately and 1 month later) or a delayed recall group (questionnaire 1 month later).
• Recalled feedback points were compared against examiner-provided feedback for quantity and accuracy.

Main Results:

• Residents recalled significantly fewer feedback points (2.61) than provided by examiners (16.3) immediately after the OSCE.
• No significant difference was found in recall between immediate post-OSCE (2.61) and 1-month later (1.96).
• Prompting immediate recall did not improve delayed recall; accuracy of recalled feedback decreased over time.

Conclusions:

• Trainees demonstrate poor recall of feedback provided during OSCEs, both immediately and after a one-month delay.
• The recalled feedback is often inaccurate and not representative of the feedback actually delivered.
• Current feedback practices in OSCEs may not effectively support learning and clinical skill development due to recall limitations.